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Check with your agency/lawyer about state laws. In NC, the law requires coverage for adopted children at placement for purposes of adoption as long as the parents have family coverage. The insurance company said no, we sent a letter along with a copy of the law and stated our confidence that they would comply with the law. Both boys were covered at birth. We have had no more problems. Peggy
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I have never heard of that. I had Healthlink and we had checked into it and the child was covered after coming into our home. Then I quit my job and we checked DH's insurance, UHC, and the coverage was the same. Now I have a new job and it is BC/BC coverage and their book also says an adopted child is covered automatically. I've never heard of after finalization, maybe talk to someone else at your insurance company? Maybe the person you spoke to did not really understand. Not sure why they would not cover your child as soon as they were brought home. If they don't it sounds like some serious education needs to be brought to them about the way they do business.
When we adopted our first daughter, the person that we initially talked to at the insurance company told us the same thing. They didn't know what they were talking about. Call again and talk to someone else - ask to speak to a supervisor if necessary. She was covered by our insurance from the moment she was placed with us. We didn't have a "family plan" at that time. I had my own insurance through my job, and dh had his own, and dd went on his policy since I was going to be quitting my job to be a SAHM. For our 2nd adoption we were asked to pay the birth expenses for our daughter, and our lawyer wrote a letter to our insurance company referencing the law wanttobeparents referenced above. It is a federal law - not a state law - stating that coverage for an adopted child begins on the "date of placement" which is actually the date that the aparents become "legally obligated" to pay the child's expenses. We were responsible for paying medical expenses for the baby from the day she was born and we were reimbursed by our insurance company for those expenses even though she wasn't physically placed with us at that time. Interestingly enough, we are in an HMO and the hospital/doctors covering the birth were out of state and not in the HMO, and the insurance company paid them anyway. You should be able to get coverage right away! Good luck! Sandy
hi, here's what adoption.com has to say about insurance: [url]http://library.adoption.com/Health-Care/Health-Insurance-for-Adopted-Children/article/5052/1.html[/url] btw, we had dd covered from her birth. we contacted the insurance company, faxed them our placement document, made a phone call, and she was covered from her birth (her birth costs were picked up by bparents and we paid copay). hope this helps, lisa
I had the same problem but when I looked into it further I finally figured out that insurance people do not understand adoption. For foster adopt it was legal finalization but for a straight adoption it was when you became the babies permanent home; ie at placement. You insurance company is probably just using the term "finalization" a different way than us adoption professionals. Get a copy of your certifcate of coverage and look under "who is an insured" It should say what you expect it to. Jen
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Hi Kelly, In 1993 President Clinton signed the Federal Omnibus Reconciliation Act, which requires that any company that provides group health care coverage is required to cover your child, at the time of placement with the intent to adopt, regardless of whether or not this adoption is final. A summary of it from online text: I have shared here before that we had a problem similar to yours with our Blue Cross Blue Shield PPO. We contacted them while we were still waiting. They said, call us when you actually adopt. I confirmed that with a supervisor who told me the same. Fast forward to our dd's birth; we contacted them. The first rep told me what they told you - the adoption had to be finalized first. I tried at length clarifying this issue with her. She was unreceptive and misinformed. I demanded to speak to her supervisor who was just as ill informed and told me the same. I faxed them the copy of the Omnibus Reconciliation Act. To make a long story short, I was contacted by a Director who apologized profusely and explained how they were all misinformed and unaware. They made my dd's coverage effective the date of her birth. Luckily we do not have BCBS now or I suspect I would have had to walk this path again when my son was born; he had a lengthy NICU stay and is followed monthly by the Cardiologist. Our current provider added him the day he was born and never requested any documentation of his birth. We faxed our finalization papers to them when he was 15 days old, so that there would be no questions. Good luck. Call them back. Ask for a supervisor. You may have to send them the documentation to get anywhere.
Buried among the sweeping changes in the Tax and employee benefits area made by OBRA '93, is one substantive change that should be of enormous benefit to the families who have adopted a child and families that are considering adoption. This change is revolutionary because it represents the first time since the promulgation of the Employee Retirement Income Security Act (ERISA) in 1974 that a particular benefit has been mandated under medical benefit plans governed by ERISA. The new law requires that any "group health plan" which provides coverage for dependent children of plan participants, must provide benefits to dependent children placed with participants for adoption under the same terms and conditions as apply in the case of dependent children who are "natural" children of participants under the plan. Thus requirement applies irrespective of whether the adoption has become final. Additionally, an employer's group health plan may not restrict coverage of any dependent child adopted by participant, or placed with a participant for adoption, solely on the basis of preexisting condition of such child at the time that such child otherwise would become eligible for coverage under the plan, if the adoption or placement for adoption occurs while the participant is eligible for coverage under the plan. The law protects children who have not attained age 18 as of the date of the adoption or placement.
I agree with other posters - it is illegal not to cover an adopted child. If you are working with an agency, check with them, too....ours has a letter to submit to our insurance company upon placement of a child that also points out the law. It encourages the insurance company to contact the adoption agency if there will be any problem with coverage so that the failure in procedure may be reported. (I love the friendly undertones used in the letter while acknowledging that they will be reported :))
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our son was covered from the moment we became his gaurdians, i found out later though that since we live in louisiana he is eligible for medecaid because until the adoption is finalized he is considered a seperate family without income. I use my insurance company for primary coverage and medecaid for secondary this takes care of any deductibles we would have had to pay
Kelly - You may want to consult your adoption attorney about getting guardianship. We are in Kentucky, and we decided to go for guardianship when our son was born to be safe. It is an extra form the bmom will sign and the judge will usually backdate the order to the date of birth. That way, we had a legal document to send to our insurance company and they covered him no problem.